Archives for June 2018

My dentist and I have been talking about doing cosmetic bonding on my front tooth on the top. I have a noticeable chip. It’s not a huge concern and I’ve been putting it off for years, but I wouldn’t mind getting it repaired. The last time I was in, they gave me a quote and it included a charge for nearly $1,000 for tooth whitening. What a racket! They’re charging me more for that then they would for the repair. I asked if it was necessary and the lady told me that the doctor always does whitening before cosmetic bonding. I’m not into that. I don’t want a fake white smile. I like mine. I just want the small chip repaired. Is this standard protocol that all dentists follow?

Thanks,

Sierra

Dear Sierra,

Every dentist sets his own guidelines, so it’s possible this is something your dentist mandates, but it’s likely there was some confusion in the communication that you got. Particularly when you work with a cosmetic dentist, his or her goal is to give you the smile you want. An experienced cosmetic dentist will work with you to identify your goals because, ultimately, you’re the one who should be ecstatic about how you look. Most don’t consider their job done until you are happy with it. To that end, you’ll hear of cosmetic dentists doing all sorts of things, including using shades of brown and yellow to match teeth or give a more natural look, provided that’s what the patient wants.

That said, if you will ever want brighter teeth, now’s the time to whiten. The cosmetic bonding can’t be lightened after the fact, so it makes sense to do the teeth whitening beforehand if you do want to go lighter. If cost is a barrier here, you can ask your dentist about doing a take-home kit. They’re still professional-grade whitening, but it’s a fraction of the cost of in-office options and the shade change happens gradually over a period of days or weeks, depending on how often you use the kit and how long you leave the trays in.

If you genuinely don’t want to lighten, talk to the dentist or have his office staff give him a message with your inquiry. It would be fairly odd for him to refuse to do the work if you don’t whiten. More than likely, the office is simply responsible for letting you know that whitening should be done first if you want it done. However, if you happen to be at an office where the dentist really won’t budge on it, you may want to get a second opinion from an alternate cosmetic dentist.

I’ve been reading a lot on this site about how the right direct composite veneers technique can transform a smile. Well, my friends and I were all sitting around at an Irish pub this past weekend and the topic of Shane MacGowan, lead singer for the Pogues came up. His teeth were destroyed for years because of drug use, but now they’re back to normal and he even has a gold tooth. I didn’t know dentists could apply gold in-office, but it looks like that’s what was done. I guess he had a documentary made about it, but I can’t find it anywhere to download. My buddies put me up to finding out what he had done- if it was a special direct composite veneers technique or something else.

Thanks,

Justin

Dear Justin,

Indeed. A few years ago, there was a documentary made about Shane MacGowan’s teeth. Fans of the Pogues had been watching his teeth deteriorate for years, to the point where even friend Johnny Depp spoke about them in an interview. MacGowan’s very public battle with cigarettes, heroin, LSD, and alcohol has been duly noted, though teeth in that state are most often attributed to methamphetamine use. Of course, MacGowan is also known for fighting, being involved in police skirmishes, and odd substance-influenced behaviors, like eating vinyl records, none of which have done his teeth any favors. That said, MacGowan has been open about his struggles, what brought him to where he was, and what getting clean and repairing his smile has been like.

Once teeth get to the stage where they’re severely decayed and broken, there isn’t a direct composite veneers technique that can save them. Veneers of any kind are cosmetic in nature. They simply cover the fronts of the teeth and work well to repair small chips, defects, and discolorations. Once there’s significant decay, full coverage in the form of a crown is necessary. In later stages, the tooth must be removed and replaced. Most dentists recommend dental implants in these cases, but dentures and bridges can also work when someone’s oral health or general health precludes having dental implants placed.

MacGowan originally had his few remaining teeth extracted and went with a denture. It’s unclear whether that’s because his health wouldn’t allow for dental implants or if it was his preference. However, the Pogues singer never took to his dentures. He had a few choice words about how they made him look, which aren’t fit for republishing in polite audiences. Years later, his long-term girlfriend went in and had a smile reconstruction done, which inspired MacGowan to do the same. This time around, he went with a comprehensive smile design, including dental implants. He worked with his dentist to create a smile that he felt suited him, choosing a darker shade to make them look more natural and including a gold crown atop one dental implant because he thought it made him look “sexy.” The crowns were likely made in a dental implant lab versus in the office, as is standard protocol. Hope this helps clear things up.